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Anyone had surgery on spine who also has osteopenia or osteoporosis
I have a double whammy. I have spondylolisthesis at L4/L5 and it causes some sciatica/left knee and leg pain that I’ve treated with epidural injections with some relief and with physical therapy. An orthopedic surgeon and two neurosurgeons have said that the only way to fix this when I’m “ready” is a fusion. I also have osteopenia - not osteoporosis yet. Took the oral meds for years and was taken off due to stable scans and some improvement. Density has decreased somewhat since two years ago and internist wants to start medication but I have reflux so she sent me a hematologist for injections - she told me that I can’t take the oral meds anymore and all she can do is Prolia. I’m reluctant so am waiting to see a new endocrinologist (I moved and had to find a new one). Wondering how anyone who has had a fusion has fared if their bone density was also low?
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I have osteoporosis and am six months post surgery for a long fusion, T4 to S1.
I’ve been on a daily injection of Tymlos since March 2021. I will need to stop in February 2023. My doctor wanted me on it for at least one year pre surgery to improve my bone strength. I’m also using a bone growth stimulator for 9 months post surgery.
In February I have all the scans to see how the bones are fusing. So far, all X-rays show that I have not had any hard ware failure.
I was told I had a 60% chance of some hardware failure. I’ve followed the rules, no bending, no lifting, no twisting. So far, so good.
I hope this helps.
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4 ReactionsI had reflux and my vitamin dr (sounds crazy also tastes terrible great for intestines )on empty stomack in the morning drink 4 oz of red cabbage juice and before bed do the same your head will be spinning manny vitamins !!!!
let me know how you do
Yes, I’ve had spinal surgery at L3 - L5, with titanium cage. I too, am osteopenic. I personally had no physical issues for over 2 years now with this surgery. (64 years old). For me, it was well worth getting it done. Good luck!
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2 ReactionsMy surgeon is recommending a two stage surgical procedure. Day 1 would involve replacing the discs at L4-L5 and L5-S1. Day 3 would be a lumbar fusion from L2 to the pelvis.
MRI indicates : severe lumbar stenosis L3-L4 central, left L4-L5 lateral
recess, bilateral L5-S1 recess
- L2-L3 dynamic, L3-L4 les dynamic high grade
retrolisthesis
-Left L4 IAP ventral subluxation and coronal
angulation =low grade rotatory spondylolisthesis
-thoracic hyperkyphosis, 60 degrees
-Left L5>S1 lumbar radiculopathy
-Lumbago
-prior left L1, L2 transverse process fractures
-T11 wedge fracture, fragility= clinical osteoporosis
I am a 58 year old female who has pins and needles in the left foot. I struggled with a painful bout of sciatica this summer but it resolved over the summer with gabapentin. I go to the gym daily to use the treadmill and and the weight machines. I started Eventity in December for osteoporosis and seem to be tolerating it well. My bone density tests have always been normal. However, I couldn't argue with see thru appearance of my bones on the radiographs.
The local neurosurgeon recommended an outpatient surgery which seemed minimally invasive. I was utterly taken aback by the 2nd neurosurgeons opinion. I am scheduled for a 3rd opinion with another local neurosurgeon next week and hoping for an additional referral to the state university hospital.
When I walk, after about 10 minutes it feels as if someone is continually tightening my shoelaces on the pins and needles foot. I also have poor balance and some lower back pain which resolves with sitting.
Lastly, I need a new knee on the left side.
Any thoughts would be appreciated.
It's great that you're being deliberate about reaching an acceptable diagnosis. It can be frustrating to hear conflicting opinions from the docs!
I had L2-5 decompression and fusion surgery last May '23. I'm a 70 yo male in better-than-average physical condition. I had managed my back/leg discomfort for literally decades with exercise, over-the-counter meds, and caution regarding not doing too much (like heavy lifting, twisting, and such). I had the firm opinion I would not endure the disruptions and unknowns of spinal surgery until I felt I had no other option.
What made the decision for me was when I started to experience what I called "sudden leg numbness" where I would go from fine to totally numb legs in literally 60 seconds. When it hit - I had to sit down immediately or I'd fall down. I grew concerned that the numbness might suddenly develop when I was in a precarious situation...like at the top of the stairs. I sought multiple opinions until I was comfortable that I had: The best facility with the best diagnostic equipment with the best docs for my case.
I am nine+ months post lumbar surgery and am 90%+ of the way back to normal. The journey has been a challenge at times but I'm glad I'm where I am now.
Are you experiencing balance issues such that you feel you might fall? How often do you get that feeling?
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3 ReactionsHi @siamesevet. I combined your discussion with an existing discussion titled "Anyone had surgery on spine who also has osteopenia or osteoporosis" - https://connect.mayoclinic.org/discussion/anyone-had-surgery-on-spine-who-also-has-osteopenia-or-osteoporosis/. While the diagnosis may be slightly different, the topic at hand is similar in trying to gauge the best steps forward with your spine health while balancing osteoporosis/osteopenia diagnoses.
@siamesevet, it is nice to read that you have been able to get multiple opinions and are being thorough in your preparation to find the best route forward. With two wildly different approaches, are you hoping to present to the 3rd appointment an option that confirms one of the other two that has already been presented to you?
I have many of the same issues. I have spent six years trying to figure out how I want to proceed. I would love to find a surgery that would allow me to resume all the activities I love but I do not what to chase something that may not exist and has the possibility of resulting in a worsening outcome. I have tried every non-surgical outcome and consulted more docs than I can count. Many surgeons do not follow patients for more than a year iso it's hard to get accurate information about their results. I use google scholar to read the most resent evidence based research. My husband does research so he helps me evaluate the quality of research. Here is a link that may help you make an educated decision. Please share any info you discover that helps you make an educated decision.
https://onlinelibrary.wiley.com/doi/full/10.1111/imj.14120-
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1 ReactionHello upstatephil,
Thank you for taking the time to share your health journey with me. I am encouraged to hear you are having positive results after your lumbar surgery. I have read about so many disappointing results after a lumbar fusion and people who would only recommend the surgery if you have intense pain.
I have not experienced the "sudden leg numbness" you describe. My difficultly with balance becomes apparent when I attempt to walk a straight line heel to toe. I tend to lose my balance and stumble to one side. I am not in any intense pain and I haven't needed NSAIDS since recovering from sciatica this past summer.
I have a third opinion with a surgeon next week, so hopefully I can reach a decision I am comfortable with.
I encourage you to keep digging until you've got a good grasp on the balance between risks of surgery vs risks deferring.
While it's helpful to read of others' experiences - each patient, each spinal condition, each surgeon...is different. Your precise surgical outcome is (unfortunately) unknowable. Hence the risk.
Are you getting opinions from neurosurgeons?
Hello upstatephil,
My appointment next week is with a neurosurgeon. The spine orthopedic dr. is the one who recommended the lumbar fusion.
Hoping for some consensus in which direction to proceed.
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